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Management of Intra-abdominal Complications of Inflammatory Bowel Disease

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Pediatric Inflammatory Bowel Disease

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Abstract

Complex inflammatory bowel disease (IBD) including fistulizing or penetrating Crohn disease (CD) and fulminant ulcerative colitis (UC) can lead to serious complications including abscess, fistula, perforation, obstruction, and toxic megacolon which require collaboration between the gastroenterologist and surgeon. Prompt diagnosis of these entities will allow for medical optimization and surgical intervention, if required. This chapter will describe the evaluation for patients with suspected intra-abdominal complications of CD and considerations for management, with a focus on intra-abdominal and pelvic abscess resulting from internal penetrating disease. In particular, medical and surgical options for treatment will be compared. Surgical emergencies and elective procedures in CD for the indications of perforation, obstruction, and stricture will be briefly reviewed. The surgical treatment of UC is the focus of Chap. 42, but the complication of toxic megacolon will also be described here.

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Author information

Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Elizabeth C. Maxwell MD & Andrew B. Grossman MD

  2. Division of General, Thoracic and Fetal Surgery, The Children’s Hospital of Phladelphia, 3401 Civic Center Boulevard, Philadelphia, PA, USA

    Peter Mattei MD

Authors
  1. Elizabeth C. Maxwell MD
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  2. Peter Mattei MD
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  3. Andrew B. Grossman MD
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Corresponding author

Correspondence to Elizabeth C. Maxwell MD .

Editor information

Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Andrew B. Grossman

  3. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Robert N. Baldassano

  4. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Judith R. Kelsen

  5. Division of Pediatric Gastroenterology & Nutrition, University of South Carolina School of Medicine - Greenville, Greenville, South Carolina, USA

    Jonathan E. Markowitz

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Maxwell, E.C., Mattei, P., Grossman, A.B. (2017). Management of Intra-abdominal Complications of Inflammatory Bowel Disease. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_40

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  • DOI: https://doi.org/10.1007/978-3-319-49215-5_40

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